Report of the National Seniors Council on Elder Abuse

What Participants Told Us

Although each regional meeting was distinct and each made a unique contribution to the National Seniors Council’s understanding of elder abuse, six themes emerged across the five sessions: 

1. Awareness
2. Knowledge transfer and information dissemination
3. Education and training
4. Research
5. Resources for community responses to elder abuse
6. Legal considerations

All six themes play a role in addressing the multiple dimensions of elder abuse. The following is a description of each theme, including examples of good practices and suggestions made by participants for possible federal action.

Awareness

Increasing awareness of elder abuse was identified as the first important step in addressing the issue. Although efforts to raise awareness are underway by various means, participants were clear about the need to strengthen these efforts for the benefit of the general public as well as for professionals, service providers and seniors themselves.

The National Seniors Council heard about several awareness-raising activities using a variety of mediums: fact sheets and pamphlets, workshops and seminars, television and radio reports, internet communication tools and school-based educational programs. For example, in Ontario, one participant explained how she visits seniors facilities and schools and uses drama and role-play to intensify the impact of her presentations on elder abuse. She has also widened access to this informational tool by making the vignettes available on CDs.

In Saskatchewan, a former law enforcement officer and sought-after expert has written and published a book entitled Stop Fraud. In Alberta, the Alberta Action Committee against Violence has produced a toolkit that teaches people how to host an“awareness café” on elder abuse that includes key messages and questions to encourage discussion about how to recognize elder abuse.

These are just a few examples of effective awareness activities currently underway. However, participants across the country were consistent in their views that efforts to increase awareness of elder abuse must be enhanced and accelerated.

Participants suggested that the federal government could consider building on existing public awareness campaigns to leverage these efforts in the development of a coordinated national awareness campaign similar to ParticipACTION. The national campaign could include partnerships with media, business, labour, academia volunteer organizations and seniors organizations to increase awareness of elder abuse.

Participants suggested building on the awareness generated by the celebration of World Elder Abuse Awareness Day (WEAAD) in Canada on June 15. WEAAD was launched by the International Network for the Prevention of Elder Abuse in 2006. The federal government and all provincial/territorial governments participated in WEAAD in 2006 and 2007, along with numerous events that took place at the community level. Through funding from federal, provincial and territorial governments, posters and information kits were developed and distributed across the country in both years.

In Toronto, it was suggested that the prominence of WEAAD could be heightened by making it part of the United Nations formal calendar. The federal government could initiate steps to examine the feasibility of formalizing WEAAD on the United Nations calendar of events.

To maximize the impact of a national awareness campaign, the following factors were identified as important to consider in the design of an approach:

• Messages must be designed to reach specific target audiences such as seniors, service providers, health care professionals, financial institutions, families and caregivers.
• The cultural diversity of Canada’s population, including its Aboriginal peoples, must be acknowledged and respected.
• Materials must be available in multiple languages.
• Specific types of elder abuse should be targeted.Footnote 3 
• Recognition that raising awareness may result in an increase in reporting incidents of elder abuse, which will in turn intensify the demand for services

Knowledge transfer and information dissemination

Knowledge transfer and information dissemination are fundamentally important to address elder abuse effectively and efficiently across the country. Participants told the National Seniors Council that in spite of current efforts at communication among those who work in the field on best practices, research and intervention strategies, these efforts need to be enhanced significantly to ensure that current information exchange is readily available.

Opportunities must be created to allow individuals and organizations to:

• Communicate with each other and share their experiences, knowledge and lessons learned;
• Access research and tools necessary to inform their work;
• Become knowledgeable about current provincial, national and international work underway, in order to avoid duplication of effort; and
• Understand how best to utilize limited human and financial resources.

Participants provided examples of good practices, where professionals from a variety of disciplines worked together to share their knowledge and develop effective interventions in situations of elder abuse. The National Seniors Council heard about a regional project in the Greater Lévis region that uses an interdisciplinary model, in which professionals meet monthly to review cases of elder abuse, share their expertise and coordinate actions to deal with reported cases.

In a community in Prince Edward Island, a similar multi-disciplinary model exists where an RCMP officer, community and seniors organizations, consumers federations and the public trustee organized a seniors safety program in which experts visit seniors in their own homes to provide information on awareness and prevention of elder abuse.

There was general agreement that a centralized mechanism was needed to facilitate the sharing of knowledge and information. An existing venue could take on this function or a stand-alone elder abuse clearinghouse could be established.

To facilitate the coordination of information dissemination and knowledge transfer, participants recommended that the federal government consider working in partnership with national organizations that have shown leadership in the distribution of information. For example, an organization such as the Canadian Network for the Prevention of Elder Abuse (CNPEA) might be a possible partner. The CNPEA consists of professionals representing a number of disciplines from across the country—social work, academia, community organizations and elder abuse consultants affiliated with provincial governments—who volunteer their time to raise awareness, share information, educate people on how to recognize elder abuse and stimulate research.

Participants suggested that the federal government launch and support an annual national symposium on elder abuse that would allow for knowledge transfer, education and information dissemination. An initial priority topic for a national symposium of this type could be “sharing good practices in the area of intervention.”

Training

Training on elder abuse is essential for professionals who provide care and service to seniors. These care and service providers are often the first to encounter seniors who could be at risk or who are victims of abuse.

Academics who participated in the regional meetings identified a need to invest in training for future health care and social service professionals, around issues of aging and elder abuse. In general, curricula for training frontline professionals are not seen as offering education on how to respond to the needs of an aging society.

However, participants did note improvements in training in some instances. For example, the National Initiative for the Care of the Elderly (NICE) is a national network of researchers and practitioners involved in the care of older adults through medicine, nursing, social work and with other allied health professionals. Its goal is to establish links between university researchers and community practitioners in medicine, nursing and social work, to develop and improve practices for the care of Canada’s seniors. The network helps develop and improve educational initiatives; introduce basic geriatric knowledge into core courses in medicine, nursing and social work; and provide specific training programs in geriatric specializations. It also develops training programs for practitioners already in the field, to help them expand and refine their skills in caring for older adults. Participants recognized NICE as a training and educational vehicle, as well as one for information dissemination, knowledge transfer and professional development.

At all of the regional meetings, participants mentioned a lack of training for personal support workers who provide services including personal care, housekeeping, shopping and companionship, among others. Specific training in elder abuse is important for personal support workers because they may work with seniors who are at risk of abuse or who are victims of abuse.

Participants also noted a lack of specialized training for those in the criminal justice system who deal with victims of elder abuse and their families. They suggested that enhanced training be considered.

Research

Participants recognized that research on elder abuse is important and suggested that it be one of the activities included in the overall action plan to address elder abuse. They felt that research alone is not the answer; but that it should be part of a comprehensive plan to ensure that actions are based on accurate and valid information.

The National Seniors Council heard about several promising research initiatives.

A Way Forward, a national research project begun in 2006 in Toronto, is one example described to the Council by a lead partner. With financial support from the Government of Canada, through the National Population Health Fund of the Public Health Agency of Canada, this project is a collaborative effort of the University of Toronto’s Institute for Life Course and Aging, and partners from six universities, as well as key community and long-term care stakeholders. The objective of the project is to enhance the capacity of communities across Canada to better understand and respond to the complex issues of abuse and neglect in institutional facilities.

Specific suggestions made by participants about the types of research that would enhance understanding of elder abuse in Canada included:

• Updating existing research on causes, incidence and prevalence of elder abuse;
• Examining the association between mental health issues, substance abuse and elder abuse;
• Examining the consequences of elder abuse, particularly on families, communities and among different ethno-cultural populations in Canada;
• Investigating the possible impact of ageism on elder abuse; and
• Designing an evaluation framework for tools and interventions to detect and respond to abuse.

It was suggested that the federal government can contribute to research on elder abuse either directly, by conducting research itself, or indirectly, by entering into partnerships with organizations that conduct research.

Resources for community responses to elder abuse

To address elder abuse, it is imperative that action take place at the community level and that resources be allocated to this. Participants delivered a unanimous message that without adequate and sustainable funding, efforts to combat elder abuse in local communities are compromised.

Participants also emphasized that not only is funding important for those who work in the field, but human resources are also critical. Many communities rely heavily on volunteers to work directly with seniors at risk, as frontline resources, coordinators and trainers. Participants suggested that the National Seniors Council urge the federal government to provide support to these volunteers, who are essential in delivering these services, but who are vulnerable to burnout.

The 2007 increase in funds for national and regional elder abuse awareness projects under the New Horizons for Seniors Program (NHSP) was viewed as a very positive development. Participants noted, however, that the parameters of the community-based funding provided by NHSP (one-time grants) do not sustain the continuation of promising local projects that address elder abuse.

Legal considerations

A number of legal remedies exist in Canada to deal with elder abuse and neglect. Along with federal criminal law defined in the Criminal Code of Canada, there are provincial and territorial frameworks pertaining to adult protection legislation, adult guardianship, family violence statutes, human rights statutes and long-term care facilities regulation.

The Criminal Code describes the different offences that someone can be charged with if they are accused of abusive actions toward older adults. The relevant provisions include those related to physical and sexual abuse, criminal harassment in situations of chronic psychological abuse, neglect, property theft, breach of trust, extortion, fraud and intimidation. In addition, sentencing provisions in the Code require the courts to consider evidence of age-based bias as an aggravating factor.

During some of the regional meetings, participants debated whether or not the Criminal Code should be amended to further facilitate dealing with elder abuse. Legal experts at the meetings, such as those representing La Commission des droits de la personne et des droits de la jeunesse, in Quebec, and the Advocacy Centre for the Elderly (ACE), in Ontario, advised that changes to existing legislation are not necessary. Effective legislation and legal tools exist that protect the rights of individuals. What is lacking is awareness of these tools and the steps that should be taken by social workers and law enforcement professionals who are often the first to encounter situations of elder abuse.

There was a strong view among participants that legal aid should be more widely available for low-income seniors and/or those who have been abused so income is not an impediment to accessing legal services.

Legal experts at the regional meetings advised that it is important to recognize that legal solutions alone are not as effective in combating elder abuse as social solutions that include the legal community. Interdisciplinary models were described, such as the one used in ACE, in which legal experts are part of a team approach that addresses all aspects of elder abuse as it occurs within families and communities in which older adults live. Participants encouraged the federal government to look at ways to further include the legal community in an interdisciplinary approach to elder abuse.

Many participants reported that the misinterpretation of the scope and intent of federal and provincial privacy legislation can be a barrier to reporting elder abuse cases.

With respect to federal privacy legislation, individuals are protected by the Personal Information Protection and Electronic Documents Act (PIPEDA), which sets out regulations for how private sector organizations may collect, use or disclose personal information in the course of commercial activities.

Initially, PIPEDA applied only to personal information about customers or employees that was collected, used or disclosed in the course of commercial activities by the federally‑regulated private sector organizations such as banks, airlines and telecommunications companies. The Act now applies to personal information collected, used or disclosed by the retail sector, publishing companies, the service industry, manufacturers and other provincially-regulated organizations, except in provinces that have enacted legislation similar to PIPEDA.

As a result, industries in the federally-regulated private sector have taken steps to ensure that they are not in violation of privacy regulations. However, examples were provided of instances where banks were reluctant to report suspected cases of possible fraud or abuse of power of attorney, claiming that they were unable to do so due to restrictions placed upon them as a result of privacy legislation. As well, healthcare professionals reported that there is reluctance to report possible physical or psychological abuse of elders for fear of repercussions due to infractions of privacy legislation.

Legal experts informed the National Seniors Council of the need to clarify whether reporting a suspicion of elder abuse violates current privacy legislation. The National Seniors Council was asked to consider how the federal government might be able to work with these sectors to ensure they understand the application of privacy legislation.

As one legal expert told the National Seniors Council, “The law is not a solution; it is a tool. One has to be able to use the law effectively when appropriate.” It was suggested that the federal government undertake an examination of federal legislative and legal frameworks to better understand how they may be utilized and applied to cases of elder abuse.